Periodontitis is a chronic inflammatory disease, resulting due to host immune response against subgingival biofilm. Most conventional treatment protocols aim to control the subgingival biofilm by mechanical means, such as dental scaling and root planning, and frequently accompanied by antibacterial co‐adjuvant therapies, including antibiotics, antiseptics, or probiotics. Local drug delivery facilitates administration of a lower dose of the drug to the target site, but at higher concentration, thereby reducing systemic adverse effects and toxicity. The present systematic review was conducted with the aim of identifying and reporting nanoparticle based periodontal drug delivery systems, with a specific focus on current trends and future perspectives in this field. Comprehensive literature search, restricted to published reports in English language between January 2000 and February 2022, was done electronically and manually. Search queries were addressed to the following electronic databases including, PubMed (MEDLINE), Science Direct (Elsevier), Cochrane Library, Web of Science (Clarivate Analytics) and Scholar (Google). Database search returned 780 results which were screened based on title, author names and publication dates, to identify 13 studies fulfilling the review criteria. Data from the 13 included studies were reviewed and tabulated, elaborating the type of nanoparticle used, drug delivered and tissues/cells/subcellular components targeted by periodontal drug delivery. While majority of the studies were conducted in vitro, there were 3 in vivo studies and 3 clinical studies. Using nanotechnology for drug delivery resulted in better inhibition of bacterial growth, inflammatory modulation favoring resolution of periodontitis and capability for early tissue regeneration. Recent developments in nanotechnology have enabled targeted local delivery of drugs and anti-inflammatory biomolecules, in synergy with nanoparticles, towards periodontal pathogens, inflammatory cells and periodontal tissues. Further research evaluating clinical periodontal disease management through nanoparticle based local drug delivery drugs is highly recommended.

Gingivitis and periodontitis are common oral pathological conditions. Several optional adjunctive local therapies are used clinically. While antibiotics and chlorhexidine are the most common agents of choice, their long-term use is associated with several adverse effects. Some of these include staining of teeth and restorations, cellular cytotoxicity and hypersensitivity. Topical oxygen therapy has been recently introduced and could be clinically capable of inhibiting plaque bacterial biofilm growth. Available as a mouthwash, toothpaste and oral gel, this formulation comprises cellulose, glycerol and sodium peroxoborate, and releases topical oxygen in a controlled manner. Moreover, it releases topical oxygen, in a controlled manner, and lactoferrin, which are capable of antibacterial action and stimulation of bone cells, respectively. The aim of this paper is to report a case of gingivitis and another case of periodontitis, both of which were successfully treated clinically with adjunctive local oxygen therapy (blue^®m). Additionally, this paper aims to review the relevant literature in terms of adjunct topical or local therapies used in the treatment of gingivitis and periodontitis, in order to understand how local therapies are helpful and to know if local oxygen therapy is a suitable clinical alternative.

This meta-analysis was to systematically investigate all preclinical researches on the possible benefits of antiosteoporotic drugs on titanium implants. Also, we performed a subgroup analysis to examine if the methods of drug delivery (systemic vs. local vs. surface coatings) or the types of antiosteoporotic drug (anticatabolic vs. anabolic) have more effect on bone-to-implant regeneration. A total of 116 articles (animal studies) were included. Poor reporting was assessed in the majority of the included studies. Then, results of meta-analysis showed that the use of osteoporotic medications significantly increased the overall values of micro-CT bone volume (BV) (mean differences [MD]: 21.7%, confidence interval [CI]: 17.8–25.7), bone-to-implant contact (BIC) (MD: 12.1%, CI: 10.6–13.7), torque-out (MD: 5.7N.cm, CI: 4.6–6.8), and push-out (MD: 67.3N, CI: 54.6–79.9) compared with the values of implants without osteoporotic medications. Also, implants coated with drugs showed higher values of BIC (MD: 16.8%, CI: 12.4–21.3) compared with implants received drugs through systemic administration (MD: 12.2%, CI: 10.1–14.3) or local administration (MD: 8.6%, CI: 5.8–11.4). A positive effect of local delivery of antiosteoporotic drugs was significant on push-out testing (MD: 169.8N, CI: 120.1–219.6) compared with the use of drugs through systemic route (MD: 51.6N, CI: 38.7–64.6) or as surface coatings (MD: 24.1N, CI: 15.4–32.7). Finally, anabolic drugs showed a significant effect on push-out forces (MD: 125.5N, CI: 95.5–155.5) compared with the use of anticatabolic drugs (MD: 51.9N, CI: 39.5–64.5). In conclusion, the positive effect of antiosteoporotic drugs on osseointegration is observed in the present meta-analysis. Mainly, antiosteoporotic drug-coated implant surfaces showed an increase of BIC% compared with implants received drugs through local routes, but not with systemic routes. Also, the positive effect of anabolic drugs seems beyond the effect of anticatabolic drugs in terms of mechanical stability of implants as tested by push-out. Impact Statement: This meta-analysis was to investigate literature on the administration of antiosteoporotic drugs as an effective adjunct therapy for implant osseointegration using in vivo animal models.

Peri-implant diseases including peri-implant mucositis and peri-implantitis are among the major causes of failure of implant-supported dental restorations. They are characterized by progressive inflammation of the peri-implant mucosa, extending to the surrounding connective tissues and leading to bone loss and implant failure. Although strict oral hygiene practices help in preventing peri-implant diseases, plaque buildup around the implant restoration leads to chronic inflammation, due to the adherent bacterial biofilm. While mechanical debridement and non-surgical therapy to remove inflamed connective tissue (ICT) form the mainstay of treatment, additional local adjunctive therapies enhance clinical outcomes. Topical oxygen therapy is known to reduce inflammation, increase vascularity, and act as a bacteriostatic measure. The use of oxygen-based therapy (blue^®m) products as a local adjunctive therapy for peri-implant mucositis and peri-implantitis can result in clinical outcomes similar to that of conventional local adjuncts such as chlorhexidine, antibiotics, and antibacterial agents. This report aims to present the clinical findings of patients with peri-implant mucositis and peri-implantitis, who were managed using local oxygen-based therapy as an adjunct to non-surgical therapy. In addition, a review of the literature about commonly used local adjuncts for peri-implant diseases has been included in the report to provide a means of comparison between conventional local adjunct therapy and topical oxygen-based therapy. Based on the reported findings and reviewed literature, local oxygen-based adjunct therapy was equally effective as conventionally used local adjuncts such as antibiotics, antibacterials, and probiotics, in treating patients with peri-implant diseases.

We evaluated the effect of osteoporotic induction after eight weeks of initial healing of bone defects grafted with a xenograft material in a rat model. Bone defects were created in the femoral condyles of 16 female Wistar rats (one defect per rat). The defects were filled with bovine bone (Inter-Oss) granules. After eight weeks of bone healing, rats were randomly ovariectomized (OVX) or sham-operated (SHAM). At 14 weeks of bone healing, all animals were euthanized. Bone specimens were harvested and processed for histological and histomorphometric analyses to assess new bone formation (N-BF%), remaining bone graft (RBG%) and trabecular bone space (Tb.Sp%) within the defect area. After 14 weeks of bone healing, histological evaluation revealed a significant alteration in trabecular bone in OVX rats compared to SHAM rats. There was lower N-BF% in OVX rats (22.5% ± 3.0%) compared to SHAM rats (37.7% ± 7.9%; p < 0.05). Additionally, the RBG% was significantly lower in OVX (23.7% ± 5.8%) compared to SHAM (34.8% ± 9.6%; p < 0.05) rats. Finally, the Tb.Sp% was higher in OVX (53.8% ± 7.7%) compared to SHAM (27.5% ± 14.3%; p < 0.05) rats. In conclusion, within the limitations of this study, inducing an osteoporotic condition in a rat model negatively influenced bone regeneration in the created bone defect and grafted with a xenograft material.

The installation of dental implants has become a common treatment for edentulous patients. However, concern exists about the influence of osteoporosis on the final implant success. This study evaluated whether an ovariectomy (OVX)-induced osteoporotic condition, induced eight weeks postimplantation in a rat femoral condyle, influences the bone response to already-integrated implants. The implants were inserted in the femoral condyle of 16 female Wistar rats. Eight weeks postimplantation, rats were randomly ovariectomized (OVX) or sham-operated (SHAM). Fourteen weeks later, animals were sacrificed, and implants were used for histological and histomorphometric analyses. A significant reduction in the quantity and quality of trabecular bone around dental implants existed in OVX rats in comparison to the SHAM group. For histomorphometric analysis, the bone area (BA%) showed a significant difference between OVX (34.2 ± 4.3) and SHAM (52.6 ± 12.7) groups (p < 0.05). Bone–implant contact (BIC%) revealed significantly lower values for all implants in OVX (42.5 ± 20.4) versus SHAM (59.0 ± 19.0) rats. Therefore, induction of an osteoporotic condition eight weeks postimplantation in a rat model negatively affects the amount of bone present in close vicinity to bone implants.